Differential Diagnosis
The patient's laboratory results show an elevated glucose level, abnormal urinalysis, and other relevant findings. Based on these results, the following differential diagnoses can be considered:
- Single most likely diagnosis
- Urinary Tract Infection (UTI): The presence of WBCs, bacteria, and a positive nitrite test in the urinalysis strongly suggests a UTI. The patient's symptoms and laboratory results are consistent with this diagnosis.
- Other Likely diagnoses
- Diabetes Mellitus: The elevated glucose level (132) may indicate diabetes mellitus, especially if the patient has other risk factors or symptoms such as polyuria, polydipsia, or weight loss.
- Dehydration: The elevated CO2 level (32) could be indicative of dehydration, which may be related to the UTI or another underlying condition.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although the patient's CBC is unremarkable, the presence of a UTI and elevated glucose level could be indicative of an underlying infection that may progress to sepsis if left untreated.
- Pyelonephritis: The patient's urinalysis results could also suggest pyelonephritis, an infection of the kidney that requires prompt treatment to prevent serious complications.
- Rare diagnoses
- Diabetic Ketoacidosis (DKA): Although the patient's glucose level is elevated, there is no clear indication of ketoacidosis. However, DKA is a rare but potentially life-threatening condition that should be considered in patients with diabetes or those at risk for developing diabetes.
- Urethritis or Cystitis due to a less common organism: The presence of WBCs and bacteria in the urinalysis could suggest an infection caused by a less common organism, such as Chlamydia or Gonorrhea, which may require specific treatment.